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Flashcards in Autoimmunity Deck (20):

What are the 4 main categories that cause autoimmune disease?

1. Hidden antigens
2. Neo antigens
3. Molecular mimicry
4. Loss of immunoregulation


Name several organ specific autoimmune disorders.

Type 1 diabetes
Graves disease
Hashimotos thyroiditis
Addisons disease
Goodpasture syndrome


What is the effect/cause of Addisons disease?

Insufficiency of glucocorticoids and aldosterone, this is because antibodies attack the adrenal cortex.
Insufficient aldosterone which is a mineralocorticoid leads to a loss of Na+ which will lower the BP/Cardiac output as this is effecting the renin-angiotensin system that help increase blood pressure. Destruction of the cortex will lead to a significant loss of cortisol which is responsible for protein catabolism and gluconeogeneis, the lack of cortisol will also make the pituitary gland overproduce ACTH which in turn affects the pigment in the skin cause the bronzed appearance.


How is Addisons disease triggered?

Addisons disease can be triggered by a TB infections, amyloidosis and following adrenalectomy.


What are the symptoms of Addisons disease?

Lethargy, weakness, weight loss nausea, vomiting, hypotension and hypoglyceamia.


Diagnosis and treatment of Addisons disease?

It is usually diagnosed late typically when majoirty of the cortex had been destroyed as symtpoms dont show up straight away. It is identified by testing the cortisol and ACTH levels in the patient. They are treated with corticosteroid replacement therapy such as hydrocortisone or fludrocortisone.


What is the effect/cause of Type 1 diabetes?

Type 1 diabetes is causes by the destruction of the beta cells of the islets of langerhans in the pancreas. It is the CD8 T cells that mediate the cells destruction this can occur after a viral infection such as Coxsackia B and can also be genetically inherited. The destruction of the beta cells leads to a absence or significantly reduced amount of insulin which is need for blood glucose regulation, this can lead to a variety of other complications such as DKA.


What are the symptoms of type 1 diabetes?

polydipsia, polyuria, weight loss, blurred vision, lethargy, and increased susceptibility to infections.


What is the effect/cause of Graves' disease?

Graves disease is a common cause of hyperthyroidism which is an increase in T3 and T4 and decrease in TSH. In Graves' disease antibodies bind to the TSHr causing the production of thyroid hormones, T lymphocytes destroy the thyroid cells.


Symptoms of Graves' disease?

exophthalmos (protrusion of eyeballs), heat intolerance, anxiety, weight loss, sweating, increased appetite, hyperkinesis (muscle spasms) and tachycardia (increased heart rate).


Diagnosis/Treatment of Graves' disease?

This can be identified through thyroid function tests. Treatment includes anti-thyroid drugs such as carbimazole or surgery.


What is the effect/cause of haemolytic anaemia?

IgG and IgM autoantibodies bind to RBCs and activate complement causing either C3b to bind to macrophages inducing phagocytosis or activating the complement cascade which will cause the membrane attack complex. RBCs coated with antibodies bind to the Fc receptors on macrophages cause phagocytosis this is induced by receptor mediated endocytosis. This causes abnormal destruction of the RBC and can become spherocytic.


What are the symptoms of haemolytic anaemia?

Fatigue, shortness of breath, dizziness, headache, coldness in hands and feet and chest pains. Jaundice and pain in the upper abdomen.


Diagnosis/Treatment for haemolytic anaemia?

Diagnosis can include physical exam, CBC, urine sample, bone marrow sample. Treatment can include medicine such as corticosteroids (prednisone) which limits the ability of the immune system attacking the RBCs.


What is the effect/cause of Rheumatoid arthritis?

This disease affects the joints due to the synovial membranes becoming inflamed and overproducing fluid, the synovial membrane can be converted to an inflammatory tissue called pannus. The cartilage and bone become damaged due to the increased pressure on the joint and the release of inflammatory proteins such as TNF-a. The initial trigger for RA is unknown.


What are the symptoms of rheumatoid arthritis?

Symptoms of inflammation including pain, redness, swelling, heat and difficulty moving the joint. Long term can result in loss of muscle to the surrounding area.


How do you diagnose/treat rheumatoid arthritis?

Main treatment method is pain relief for the patient such as NSAIDs, others include disease modifying antirheumatic drugs (DMARDs) such as methotrexate and leflunomide. These drugs slow down the damage cause by RA.


Affects/causes of multiple sclerosis?

It is caused by the destruction of the myelin sheath which begins with the initiation of the innate immune system. The effect of the T cells causes CD4 to differentiate into TH1 cells and induce inflammation. Once the adaptive immune response is activated T-cells ontinue to differentiate into Th1, TH2 and Th17. Th1 and 17 produce inflammatory cytokines which leads to the demylination of the axons. This can cause a variety of complications such as muscle loss, vision disturbances and loss of bodily function.


What are the symptoms of multiple sclerosis?

There are 4 types of MS so the symptoms can vary depending, but usually they have a lack of coordination, muscle weakness, fatigue, cognitive changes such as mood and loss of vision.


Treatment for multiple sclerosis?

Treatment include: IFN-b drugs and monoclonal antibodies.